Tuesday, January 24, 2012

Another Planet Heard From: Sunshine Law is Useless

I had not heard recently from Dr. Thomas Stossel of ACRE fame (see for example http://brodyhooked.blogspot.com/2010/04/federal-settlements-acre-perspective.html). However, the redoubtable Dr. Stossel now appears on the op-ed page of the Wall Street Journal ("Who Paid for Your Doctor's Bagel?" January 23, p. A17; subscription required), to inform us that the Sunshine Act provisions included in the Affordable Care Act, due to take effect later this year, are "toxic" and "inverts reality."

I have felt for some time that Dr. Stossel lives on another planet. On his planet everything is just fine between medicine and Pharma, at least so long as the evil government, and goody two-shoes folks like me, don't interfere. Docs get paid big bucks by Pharma. As a result they think fine thoughts and invent great new drugs. These great new drugs then make us all live longer and better. Eeveryone wins, and there's no downside. Dr. Stossel reports that medicine can today do wonderful things that we could not do when he graduated from med school in 1967--I didn't realize he was that old, I graduated in 1976 and feel pretty much fossilized myself--an assessment of progress with which I totally concur. He believes that all of it is due to the free enterprise business model that he advocates.

So what doesn't happen on Dr. Stossel's planet, that in my humble opinion happens on this one? First, drugs only help people and never hurt them, and companies never market potentially dangerous drugs to people who don't need them. Revelations such as Dr. Don Light's about the harm caused by prescription drugs apparently are irrelevant there: http://brodyhooked.blogspot.com/2010/08/how-many-new-drugs-are-lemons-ask.html.

But perhaps the most fascinating difference between the two planets is Dr. Stossel's claim, "Having failed to detect substantive corruption due to physician-industry relationships over a quarter century, [critics] will spend taxpayer-provided grant money" to keep searching for the supposedly non-existent corruption.

There's no "substantive" corruption because when the industry pays docs, it is always strictly on the up and up. Physicians are "compensated by royalties from useful inventions that they license to companies, or ...were paid consulting fees for advice concerning the optimal use of products, or for educating other physicians about products." On that other planet, docs are never paid bribes by industry to prescribe their drug or device, or to persuade their fellow physicians to do likewise. Funny how on this planet seldom a week goes by that I'm not blogging about some such corruption at the medicine-industry interface.

But then again, I suppose that the corruption that I have been blogging about all these years is not "substantive" enough. So just who "inverts reality"?